Top 10 Questions About Online Speech Therapy From School Districts (Part 1)

During a recent webinar, a panel of experts answered school district leaders’ questions about online speech therapy such as the research behind it, its actual effectiveness and the practical issues of implementation . Their answers are based on real world experience, published research and the ongoing development of best practices in this emerging field.

We have decided to spread out this Q&A in three parts to allow readers to fully engage in these responses by sharing this content with their peers and asking us here at PresenceLearning some additional questions as well.

The panel of experts included:
• Melissa Jakubowitz, M.A.,CCC-SLP, BRS-CL VP of SLP Clinical Services, PresenceLearning
• Dr. Shari Robertson, Ph.D., CCC-SLP Professor of Speech-Language Pathology, School of Graduate Studies and Research, Indiana University of PA
• Dr. Lynda Donahue, Ed.D. Special Education Director for Vacaville Unified School District (retired June 2012).
• Erika Bare, Special Education Project Specialist, Medford School District, Oregon.

The Persistent SLP Shortage: A Big Issue Facing School Leaders
A top issue identified by school leaders concerned with the delivery of speech-language services is the critical shortage of SLPs. Districts need more than 6,000 more SLPs than they have to serve their students. More SLPs are leaving the profession than university graduate programs produce. SLPs are leaving their jobs in alarming numbers due to burn-out or retirement. SLPs get burned-out due to excessive caseloads, lost productivity with drive time, and other work stressors. Those who remain shoulder extra burden, making a difficult situation even worse.

One way to close the SLP gap is with online delivery. In fact, online speech therapy is one of the best options we have to deal with the shortage and to provide all students with services they need. Online speech therapy uses computers and the Internet plus live speech-language pathologists to deliver services via live video-conferencing, bridging distances of hundreds or thousands of miles between the therapist and the client receiving services. School administrators have questions about how online speech therapy works. Here are the “top 10” questions heard most often with answers from the experts.

Question #1: Is online speech therapy effective?

A. Dr. Shari Robertson: The short answer is that yes, it is effective, and a wide range of research has backed this up. Although the conversation about delivering speech/language interventions online began in earnest just recently, there is a substantial amount of research related to this method that has been undertaken over the past few decades. For example, in 1997, the Mayo Clinic endorsed telemedicine services related to speech/ language pathology as reliable, beneficial and acceptable. In addition, other research strongly suggests that speech/language services delivered online provide benefits at least equal to face-to-face services. In a 2002 meta-analysis, Reynolds noted a positive outcome at least equivalent to in-person intervention in 27 out of 28 studies. These impressive findings have been replicated in more recent studies in which researchers have consistently found SLP services delivered online result in outcomes that are equivalent, and in some measures, superior to face-to-face services.

Studies have focused on virtually every disability area and there are many notable studies for disorders typically found in school settings. For example, research at the University of Massachusetts, Amherst, found that online speech therapy is a promising service delivery model for the treatment of individuals with autism, and that includes assessment, behavior management, and progress in the educational setting. Partnering with the Ohio Dept of Education, researchers from Kent State, lead by Grogan and Johnson focused on remediation for speech articulation and speech/sound disorders. The results, which have been replicated in many studies, indicate that treatment for speech/sound disorders is at least as effective as traditional interventions. They found that for some measures, students receiving intervention with online speech therapy outperformed students receiving traditional face-to-face services. Researchers from the Australian Stuttering Center at the University of Sydney have developed online speech therapy applications for the delivery of stuttering treatment to children. Again, results were positive for reducing stuttering for all clients who participated. There are many other studies that validate the effectiveness of online speech therapy, too many to cover here.

Q2. Is online speech therapy an appropriate delivery model to treat all students with all kinds of disorders?

A. Dr. Shari Robertson: Yes, there is a wide range of disorders that can be treated successfully with online speech therapy including articulation and language disorders as well as pragmatics. But online speech therapy is not a magic wand to fix all our challenges; it’s not a one-size-fits-all proposition. Not all students are good candidates for online speech/language therapy delivered online. Contraindications include the need for physical contact and needing hands-on guidance, or when attention, hearing, vision and cognitive deficits would interfere. Also, it’s essential that there is a facilitator with proper training on site to provide appropriate support while students interact with the SLP online. The bottom line is this: we make decisions everyday about the appropriateness of various solutions to address the service delivery model for our students, and it’s no different with online speech therapy. We need to consider each student’s physical, emotional, behavioral, and cultural needs when we consider the suitability of online speech therapy as a delivery option.

Q3. What about online speech therapy for groups of students?

A. Dr. Shari Robertson: Individual as well as group sessions can be conducted online, both producing very good outcomes. The research to date has focused on individual sessions because it’s cleaner to interpret the data than for group scenarios. However, this is no different than traditional intervention. Decisions made about individual or group intervention is, by law, supposed to be based on the needs of each child. We need to think about each child, and what is going to be most effective, group or individual. This really is no different than what we need to consider for face-to-face interventions.

In practice, we know there are a number of models for online group intervention that work very well. Group intervention can be provided online in similar way to an individual session. You could have two students in the same room, participating together in an intervention activity with an SLP at a different location. You could have two students, each in a different location, working on an activity with an SLP in a third location; or you could have a group of three students, two participating in the same room, and one in another, and all three participating in an activity with an SLP at yet a different location. This is just a sample of how groups can be formed. There are multiple configurations possible for online delivery for students with similar speech language disorders. How big the group is and how it is configured depends on what is right for each student. Just as for face-to-face interventions, we make decisions about group size and group configurations based on the needs of the students involved. [To see what this looks like, go to /app/uploads/2012/08/]

Stay tuned for the next part of this Q&A series that will be released this Thursday here on the PresenceLearning blog. Feel free to leave us some questions in the comments section and by tweeting us @PresenceLearn.

Myth or Fact about Online Speech Therapy